Bursitis is the inflammation of the small fluid-filled pads, or bursae, that act as cushions among your bones and the tendons and muscles near your joints. Bursitis occurs when the bursa become
inflamed, and often occurs in joints that perform frequent and repetitive motion. The foot only contains one naturally occurring bursal sac between the Achilles tendon and the heel bone, which
protects the Achilles from the pressure against the heel bone during ambulation. However, shoes may put pressure on this bursa. The bursa might also incur trauma from walking on hard ground. And,
though they are not naturally occurring, bursa sacs can also form, and become inflamed, in other parts of the foot, including the bottom of the heel, and the metatarsal plate, the outside of the foot
below the fifth toe, and so on.
Feet are extremely resilient and are designed to stand up to the pressures of day-to-day living. In some cases, though, foot structures may break down when subjected to chronic stress associated with
long periods of weight-bearing activity on concrete, asphalt, or other hard surfaces (especially when footwear does not allow for proper weight distribution). Foot problems, including infracalcaneal
bursitis, are often made worse by poorly designed footwear, and pressure, impact, and shear forces can damage the feet over time. Bursal sacs are intended to minimize this damage, but sometimes the
bursa itself becomes inflamed. A rapid increase in physical activity levels or thinning of the heel?s protective fat pad are factors that may contribute to infracalcaneal bursitis. Other possible
causes of infracalcaneal bursitis include blunt force trauma. Arthritic conditions. Acute or chronic infection. The following factors may increase a person?s risk of bursitis, including
infracalcaneal bursitis. Poor conditioning. Exposure to cold weather. Participating in contact sports. Having a previous history of bursitis in any joint. Heel striking when running, especially in
conventional running shoes with heel elevation.
Achiness or stiffness in the affected joint. Worse pain when you press on or move the joint. A joint that looks red and swollen (especially when the bursae in the knee or elbow are affected). A joint
that feels warm to the touch, compared to the unaffected joint, which could be a sign that you have an infection in the bursa. A ?squishy? feeling when you touch the affected part. Symptoms that
rapidly reappear after an injury or sharp blow to the affected area.
When a patient has pain in a joint, a careful physical examination is needed to determine what type of movement is affected and if there is any swelling present. Bursitis will not show up on x-rays,
although sometimes there are also calcium deposits in the joint that can be seen. Inserting a thin needle into the affected bursa and removing (aspirating) some of the synovial fluid for examination
can confirm the diagnosis. In most cases, the fluid will not be clear. It can be tested for the presence of microorganisms, which would indicate an infection, and crystals, which could indicate gout.
In instances where the diagnosis is difficult, a local anesthetic (a drug that numbs the area) is injected into the painful spot. If the discomfort stops temporarily, then bursitis is probably the
Non Surgical Treatment
Orthotics may assist heel bursitis by providing stability to the heel, reduce any foot functioning abnormalities and provide extra support for the feet. The orthotic achieves this by maintaining
correct foot posture, therefore facilitating normal functioning of the Achilles tendon. Icing the back of the heel post activity for temporary relief. Non-steroidal anti-inflammatory medication such
as ibuprofen can reduce inflammation of the bursa. Stretching of the calf muscle may reduce the pulling on the heel by the Achilles tendon. Shoes that have an elevated heel may reduce pulling on the
heel from the Achilles tendon. Resting the painful heel may reduce inflammation and pain. Surgical removal of the painful bursa is a last resort treatment when all other treatments have failed.
Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a
pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle
or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be
underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).
Maintain proper form when exercising, as well as good flexibility and strength around the ankle to help prevent this condition. Proper stretching of the Achilles tendon helps prevent injury.